Various forms of suturing devices are known in the art, and those which utilize a curved needle are particularly relevant to the present invention. For example, U.S. Pat. Nos. 4,027,608 and 4,235,177 to Arbuckle, 4,406,237 to Eguchi et al., 4,417,532 to Yasukata, and 4,440,171 to Nomoto et al. describe suturing devices that use a reciprocating curved needle and means for looping and/or securing a suture thread; U.S. Pat. No. 4,557,265 to Andersson, describes a suturing device and method for moving an arcuate needle in a closed path through opposite edges of a tissue incision to complete a suture; U.S. Pat. No. 4,899,746 to Brunk describes a suturing device incorporating a curved needle into a motor driven cassette; and, U.K. Patent No. 18,602 to Mitchell describes a suturing device utilizing an arcuate needle having two recesses on remote ends of the needle which are capable of being engaged by two mating tooth-like projections on the surface of a band.
There are various drawbacks, however, with the prior art. For instance, the apparatuses described in Arbuckle, Eguchi, Yasukata and Nomoto use a reciprocating needle. These devices therefore require an added mechanism for looping and/or securing the suture thread. The added mechanism, however, unnecessarily increases the size of the suturing device making it impractical for suturing in small or crowded areas, such as, internal body cavities. Notwithstanding that problem, the added mechanism is also less efficient for tying a suture knot when compared to the semi-automatic knot tying capabilities of the present invention.
There are prior art devices which do not require the added thread looping mechanism. In general, these devices utilize a fully rotating arcuate needle. These instruments, however, pose a potential health risk to surgery patients. For instance, instruments as described in Andersson and Brunk both utilize friction rollers to drive a curved suturing needle through biological tissue. The suturing needle, however, does not positively engage the friction rollers (and vice versa), and therefore, the needle is not prevented from slipping and embedding in a patient. This most likely occurs when the needle encounters a friction force from the tissue being sutured greater than the friction force of the rollers driving the needle. Needle slippage can be avoided by ensuring positive engagement of the needle with a driving mechanism like the apparatus described in Mitchell. However, even the Mitchell apparatus, poses the same risk of embedding the needle in a patient where either tooth on the band fails to engage with its sole mating recess on the needle. Therefore, as evidenced by the prior art, there is a need for a suturing apparatus which overcomes these apparent problems.
Also known in the art are suturing instruments for arthroscopic surgery, laparoscopic procedures, and other small-scale surgical applications. For example, U.S. Pat. Nos. 1,822,330 to Ainslie, 3,871,379 to Clarke, 4,597,390 and 4,621,640 to Mulhollan et al., 4,781,190 to Lee, 4,923,461 and 4,957,498 to Caspari et al., 5,047,039 to Avant et al., and 5,059,201 to Asnis describe devices related to these medical procedures. None of these devices, however, utilize an arcuate suturing needle. As a result, these devices are bulkier, less efficient and less accurate for performing such procedures than the present invention described herein.